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				<section class="content-header">
					<h1>
						撤销记录查询
						<small>
							
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							<a href="#"><i class="fa fa-home"></i>后台首页</a>
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						<li><a href="#">撤销记录管理</a></li>
						<li class="active">撤销记录查询</li>
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<div class="box box-primary">
	<div class="box-header with-border">
		<h3 class="box-title">撤销记录查询</h3>
	</div>
	<div class="box-body table-responsive">
		<form class="form-horizontal" method="get">
		<div class="box-body">
			<div class="form-group">
				<label class="col-sm-2 control-label">撤销日期</label>
				<div class="col-sm-2">
					<input type="text" class="form-control" rel-action="datepicker" name="start_time" value="<?php echo ($data["start_time"]); ?>" placeholder="请输入支付完成日期"  autocomplete="off">
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					<input type="text" class="form-control" rel-action="datepicker" name="end_time" value="<?php echo ($data["end_time"]); ?>" placeholder="请输入支付完成日期"  autocomplete="off">
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				<label class="col-sm-2 control-label">合同编号</label>
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				</div>
			</div>
			<div class="form-group">
				<label class="col-sm-2 control-label">姓名</label>
				<div class="col-sm-4">
					<input type="text" class="form-control" name="name" value="" placeholder="请输入姓名"  autocomplete="off">
				</div>
			</div>
			<div class="form-group">
				<label class="col-sm-2 control-label">手机号</label>
				<div class="col-sm-4">
					<input type="text" class="form-control" name="mobile_number" value="" placeholder="请输入手机号"  autocomplete="off">
				</div>
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			<div class="form-group">
				<label class="col-sm-2 control-label">合同状态</label>
				<div class="col-sm-10">
					<select class="form-control" rel-action="select" name="contract_status">
						<option value="all">所有</option>
						<?php if(is_array($data["contract_status_list"])): foreach($data["contract_status_list"] as $key=>$item): ?><option value="<?php echo ($key); ?>"><?php echo ($item); ?></option><?php endforeach; endif; ?>
					</select>
				</div>
			</div>
			<div class="form-group">
				<label class="col-sm-2 control-label">审核状态</label>
				<div class="col-sm-10">
					<select class="form-control" rel-action="select" name="status">
						<option value="all">所有</option>
						<?php if(is_array($data["status_list"])): foreach($data["status_list"] as $key=>$item): ?><option value="<?php echo ($key); ?>"><?php echo ($item); ?></option><?php endforeach; endif; ?>
					</select>
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				<div class="col-sm-offset-2 col-sm-10">
					<button type="submit" class="btn btn-default">查询</button>
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				<div class="pull-right hidden-xs">
					<b>Version</b> 2.3.3
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				<strong>Copyright &copy; 2016.</strong> All rights reserved.
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